The quest for meaningful theory in health psychology

Comprehending Nutrition and Lifestyle Behaviors of People with Metabolic Syndrome: A Focus Group Study

Demographically and socio-culturally appropriate care is critical for empowering people with metabolic syndrome (MetS) to self-manage their condition. This focus group study aimed to explore the understanding of nutrition and lifestyle behaviors (NLBs) of Malaysians with MetS. Adults with MetS (N = 21) participated in four focus groups at a university's research clinic in Malaysia. A thematic framework analysis approach was applied to the focus group data using an initial coding framework developed from the Health Belief Model. Six main themes were identified on perceived motivations, barriers, and threats toward healthy NLBs. Motivations to adopt healthy NLBs were body image, personal experience of adverse complications, and family and social support. The perception that healthcare is a business model, the idea that changes in NLBs are difficult and expensive, and cultural influence on food intake were identified as barriers to healthy NLBs. Inadequate knowledge of MetS was identified as a subtheme in this study. Health education and health promotion activities that aim to modify the NLBs of people with MetS should consider the community's perception of motivation and barriers to change. Addressing these aspects in the development of programs can potentially increase program adoption and adherence, ensuring the success of community-based lifestyle interventions.

Use of modern contraceptives in Lagos Nigeria during the COVID-19 pandemic

We estimated modern contraceptive prevalence rate (mCPR) and examined predictors of modern contraceptives utilization amongst 1,445 sampled reproductive age women in Lagos (Nigeria's epicenter) during the devastating COVID-19 pandemic. Estimated mCPR was 30.8%. Women aged 20-29 years were 50% (95%CI:0.37-0.71) less likely to use modern contraceptives during the pandemic than those 30-39 years. Married and divorced women were about three (95%CI:1.37-5.25) and over three (95%CI:1.32-7.79) times more likely to use modern contraceptives compared to single women. Though mCPR has not reduced, sustained contraceptive needs assessment of sometimes obscure sub-populations is required, especially if outbreaks like COVID-19 become our 'new normal'.

Factors Associated with Sexual Risks and Risk of STIs, HIV and Other Blood-Borne Viruses Among Women Using Heroin and Other Drugs: A Systematic Literature Review

This systematic literature review identified factors associated with sexual risks related to sexually transmitted infections (STI), HIV and other blood-borne viruses (BBV) among women using heroin and other drugs. The search strategy included five databases (PubMed, EMBASE, PsycNET, Web of Science, Scopus), and PsycEXTRA for grey literature. Out of the 12,135 publications screened, 30 peer-reviewed articles were included. Most publications were cross-sectional (n = 25), quantitative (n = 23) and included 11,305 women. Factors identified were: (1) socio-demographics; (2) gender roles and violence against women; (3) substance use; (4) transactional sex; (5) partner characteristics, partner's drug use, and context of sex; (6) preferences, negotiation and availability of condoms; (7) HIV status and STIs; (8) number of sexual partners; (9) love and trust; (10) reproductive health and motherhood; and (11) risk awareness and perception of control. Overall, this review highlights important implications for future research and practice, and provides evidence for developing STI/BBV preventive strategies.

Problem gambling and help seeking among Chinese international students: narratives of place identity transformation

This article uses examples of problem gambling and help seeking among Chinese international students in New Zealand to demonstrate place identity transformation. Two-wave narrative interviews were conducted with 15 Chinese international students. Place identity among participants is shown to be a process that features the transformation of participants' identity. While the casinos in which the Chinese international students gambled gave rise to negative place identities, positive place identities facilitated the participants to change their problematic gambling. Through the investigation of place identity transformation, this article promotes a strength-based, non-labelling approach to intervention for people who are concerned about their gambling behaviours.

Competing patient and professional agendas in service development

PURPOSE

The purpose of this paper is to engage stakeholders in the development of a community based chronic pain-management service and identify their different agendas for service design and delivery.

DESIGN/METHODOLOGY/APPROACH

Data were collected using the Nominal Group Technique (NGT), a ten-step process that generates qualitative and quantitative data. Seven NGT groups were conducted in the south-west region of the UK, three with General Practitioners and nurses, three with chronic pain patients, and one with Healthcare Commissioners.

FINDINGS

The patient agenda for service development focused on process of care issues particularly the need for deep- empathy and emotional support from providers, while professionals prioritised cost-effectiveness. While there was some overlap between agendas they were largely discrete and often contradictory.

RESEARCH LIMITATIONS/IMPLICATIONS

- The findings imply service planners will need to make trade-offs between cost-containment and patient satisfaction. The methodology did not allow trade-offs to be put to participants in a structured form. However, such techniques are available, for example, Conjoint Analysis. There may also be value in bringing together patients and professionals in joint focus groups, to see if the gap between their different agendas can be bridged through discussion.

ORIGINALITY/VALUE

The findings provide a novel insight into the competing agendas of patients and professionals regarding service development and design which will be of value to service planners and managers as they strive to reconcile these differences.

The role of schools in promoting inclusive communities in contexts of diversity

Against the background of evidence for links between ill-health and prejudice, in this article we discuss how to promote inclusive communities in contexts of diversity. A brief critical overview of dominant psychological approaches to prejudice reduction reveals the apolitical nature of these approaches, and thus, we argue for a more contextual and political model on how to promote inclusive communities. Drawing on examples of different school practices on cultural diversity from across England, we argue that we need to develop a perspective that connects local contexts of everyday practice, resistance and agency to the institutional and structural realities of prejudice.

An empirical test of the Theory of Planned Behaviour applied to contraceptive use in rural Uganda

There is a high unmet need for contraceptives in developing countries such as Uganda, with high population growth, where efforts are needed to promote family planning and contraceptive use. Despite this high need, little research has investigated applications of health-behaviour-change theories to contraceptive use among this population. This study tested the Theory of Planned Behaviour's ability to predict contraceptive-use-related behaviours among post-partum women in rural Uganda. Results gave modest support to the theory's application and suggest an urgent need for improved theory-based interventions to promote contraceptive use in the populations of developing countries.

Making and maintaining lifestyle changes after participating in group based type 2 diabetes self-management educations: a qualitative study

BACKGROUND

Disease management is crucial in type 2 diabetes. Diabetes self-management education aims to provide the knowledge necessary to make and maintain lifestyle changes. However, few studies have investigated the processes after such courses. The aim of this study was to investigate how participants make and maintain lifestyle changes after participating in group-based type 2 diabetes self-management education.

METHODS

Data was collected through qualitative semi-structured interviews with 23 patients who attended educational group programs in Central Norway. The participants were asked how they had used the advice given and what they had changed after the course.

RESULTS

Knowledge was essential for making lifestyle changes following education. Three factors affected whether lifestyle changes were implemented: obtaining new knowledge, taking responsibility, and receiving confirmation of an already healthy lifestyle. Four factors motivated individuals to maintain changes: support from others, experiencing an effect, fear of complications, and the formation of new habits.

CONCLUSION

Knowledge was used to make and maintain changes in diet, medication and physical activity. Knowledge also acted as confirmation of an already adequate lifestyle. Knowledge led to no changes if diabetes appeared "not that scary" or if changes appeared too time consuming. Those involved in diabetes education need to be aware of the challenges in convincing asymptomatic patients about the benefits of adherence to self-management behaviour.

Beyond belief

Psychology, including health psychology, frequently invokes the concept of belief but almost never defines it. Drawing upon scholarship associated with the ‘affective turn’, this article argues that belief might usefully be understood as a structure of socialized feeling, contingently allied to discursive practices and positions. This conceptualization is explained, and its implications for health psychology discussed with respect to research on religiosity and spirituality and debates about the value of social cognition models such as the theory of planned behaviour.

Habits and routines in the daily management of hypertension

Two purposive case studies illustrate the role of habits and routines in illness management and how they are addressed in the clinical encounter. We argue habits and routines are related, but distinct constructs, and that by overlooking habits and routines, providers may be missing key opportunities to influence behaviour change. Utilization of ‘habit-changing’ professionals or health coaches who have the opportunity to communicate with patients on a regular basis in their daily living environment is proposed.

Pre-existing beliefs and expectations influence judgments of novel health information

The present study examined whether health information is judged differently depending on pre-existing beliefs and expectations. People's initial beliefs and expectations were assessed by a questionnaire about acupuncture and a trustworthiness and preference rating task of doctors' faces. Then, newspaper headlines about novel acupuncture treatment were shown and rated for their feasibility in a normal and framed condition. The judged feasibility of the newspaper headlines correlated strongly with initial beliefs about acupuncture in the normal condition, and with initial expectations towards a doctor's face in the framed condition. Thus, as suggested by Bayes Theorem, pre-existing beliefs and expectations influence judgments of novel health information.

The applicability of the Theory of Planned Behaviour in predicting adherence to ART among a South African sample

We sought to determine the extent to which the Theory of Planned Behaviour (TPB) was applicable in predicting medication adherence among South Africans receiving antiretroviral therapy (ART). Regression analyses revealed that the linear combination of attitudes towards adherence, perceived behavioural control and perceived group norms explained 12 percent of the variance in intentions to adhere to ART. We also found a non-significant relationship between intentions to adhere to treatment and self-reported adherence. The results call into question the extent to which TPB is helpful in understanding a health-promoting behaviour such as medication adherence among South Africans receiving ART.

Gardens, transitions and identity reconstruction among older Chinese immigrants to New Zealand

Psychologists have foregrounded the importance of links between places and daily practices in the construction of subjectivities and well-being. This article explores domestic gardening practices among older Chinese immigrants. Initial and follow-up interviews were conducted with 32 Chinese adults ranging in age from 62 to 77 years. Participants recount activities such as gardening as a means of forging a new sense of self and place in their adoptive country. Gardening provides a strategy for self-reconstruction through spatiotemporally establishing biographical continuity between participants' old lives in China and their new lives in New Zealand.

Cancer ward: patient perceptions in oncology

The novel Cancer ward (Solzhenitsyn, 1968) was used to examine the perceptions that cancer patients hold regarding their illness and its treatment, and how these perceptions relate to theoretical models in health psychology. Excerpts were identified, categorized and interpreted using the Self-Regulation Model of illness. The model's dimensions of illness perceptions were apparent throughout Cancer ward. Patients held specific representations about cancer, many of which are similar to those found today. Analysing a novel on cancer provides insight into patients' embodied experiences and perceptions of cancer and treatment. Incorporating illness perceptions into medical care improves the quality of life of patients.

What sense do people make of a theory of planned behaviour questionnaire?: a think-aloud study

This study aimed to understand the processes of interpretation of, and responses to, the task of completing a theory of planned behaviour (TPB) questionnaire. Forty-five adults verbalized their thoughts while completing a full TPB questionnaire on walking behaviour. On average, participants' verbalizations indicated around 16 problems with the 52 questions. Further, problems as identified from verbalizations were associated with increased endorsement of the middle option on the questionnaire. Normative and intention questions were found to be particularly problematic. The current standardized method to develop TPB measures systematically yields problematic questions, as indicated by both talk and questionnaire responses.

Human exploitation is not a joke--so don't laugh!

In a previous article, I called for an open discussion and debate on health psychology perspectives on social and political issues relevant to health, in particular the issue concerning racism and the media (Estacio, 2009). In this article, I raise three topics for discussion which the controversial BBC 'Harry and Paul' sketch (un)intentionally exposed to the public domain: (1) racist humour, the media and health; (2) human rights abuses against domestic workers; and (3) third world poverty and labour migration. Its implications on health psychology theory, research and practice are also explored.

Editorial: media exploitation, racism and health

The BBC comedy show ;Harry and Paul' sparked media controversy in the UK and around the world for inciting stereotyped racial discrimination, vulgarity and violation of human rights when it portrayed a Filipino domestic worker as a sex toy in Episode 4 of the series. This incident raises the issue concerning the media's role in framing social issues and how it affects the wider determinants of health. There is a need for health psychology as an academic discipline to engage more in these issues. The Journal of Health Psychology provides a unique platform for discussion and debate of perspectives on racism, the media and health.